Measles (Rubeola)

Due to the highly contagious nature of this virus, suspected cases should be isolated and immediately reported to the local public health department. Reporting should not be postponed to wait for lab results.

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Measles Vaccination

The Advisory Committee on Immunization Practices (ACIP) recommends that children receive the first dose of MMR vaccine at 12–15 months of age and the second dose between 4 to 6 years of age (or no sooner than 28 days after the first dose). All school and college students should receive two doses of MMR vaccine. Some adults should also get MMR vaccine: in general, anyone older than 18 years of age who was born in 1957 or later should get at least one dose of MMR vaccine unless they can show they had the vaccine or measles disease or they have a blood test that shows they are immune to measles.

Reporting Requirements

• Health Care Providers, Health Care Institutions, and Correctional Facilities
• Clinical Laboratories
• Schools, Child Care Establishments, and Shelters

Characteristics

• Infectious Agent: The measles virus is a paramyxovirus, genus Morbillivirus.
• Mode of Transmission: Either through direct contact with infectious droplets on contaminated surfaces or through airborne spread (tiny droplets suspended in the air for 2 hours or more).
• Communicability:  Cases are infectious one day prior to prodrome (4 days prior to rash onset) until 4 days after rash onset.
• Incubation Period:  The incubation period from exposure through prodrome is generally 10 to 12 days. The period from exposure through onset of rash averages 14 days, with a range of 7 to 18 days.
• Clinical Features
• Prodrome:
• Usually lasts 2-4 days, but can range 1-7 days. Fever and malaise last about 24 hours with the fever gradually increasing as high as 103°F-105°F. Cough, coryza, and conjunctivitis are generally present. Koplik’s spots may occur 1-2 days prior to the rash through 1-2 days after rash onset. These appear as pinpoint, raised, blue-white spots on the bright red background of the buccal mucosa.
• Rash:
• Maculopapular and usually lasting 5-6 days, the rash begins at the hairline then involves the face and upper neck. During the next three days it gradually proceeds downward and outward, reaching extremities last and being less pronounced on hands and feet. The rash usually becomes confluent on face and chest then fades in the same order that it appears, from head to feet.

Arizona Administrative Code: R9-6-347 - Measles (Rubeola)

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